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Patient Visibility

Group IV. Patient Visibility. Ann Rogers Kushal Waghmare Wanlin Xiang. Patient Visibility What and Why?. Monitoring Noting changes in state Preventing falls Preventing suicide Verifying alarm falsity/veracity Improved workflow

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Patient Visibility

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  1. Group IV Patient Visibility Ann Rogers Kushal Waghmare Wanlin Xiang

  2. Patient Visibility What and Why? • Monitoring • Noting changes in state • Preventing falls • Preventing suicide • Verifying alarm falsity/veracity • Improved workflow • Remembering patient conditions (out of sight, out of mind) • Toyota Lean Principles Physical sightlines between patient and care staff (Open doors and blinds; Adequate lighting)

  3. Visibility Analysis Visibility can be measured/calculated mathematically • No. of unique points visible from a particular point • Visibility Plots • Generic Visibility vs. Target Visibility

  4. Spatial Positioning Tool Markhede and Carranza proposed an isovist based automated model developed in Java • Measures visual relationship among selected positions • Isovist = (2d polygon – shadow space) • I/P file is a dxf file which contains 2d information

  5. Current Configurations Parallel Corridor Open/Closed Surrounded Off Beds Spokes With End Station Embedded U-Shaped Spokes, No End Station

  6. Visibility -> “Visibility” Physical proximity to patients = better than direct sightlines • HKS Study: • Increased socialization, mentoring, consulting • In class: Empathy and Rapid assessments • Smell, Hearing Outboard Inboard

  7. Observations Mortality rates of High-Visibility vs. Low-Visibility Rooms • Mortality rates (HVR) < Mortality rates (LVR) • Especially in Cardiac Arrests and Respiratory Issues • Patients have very little time to recover

  8. NICU and PICU Neonatal & Pediatric ICUs • More vigilant, careful monitoring required • Signals indicating change in medical conditions are very subtle • NICUs should provide good visibility to infants • Control stations: within close proximity and direct visibility of newborn care area. • Incubators should be transparent from at least 3 sides to allow maximum visibility

  9. When a re-design isn’t possible • Higher nurse to patient ratio • Minimize peer-to-peer relationships among nurses with decentralized nursing stations • Place sickest patients in most visible rooms

  10. DOs • Position of the headwall canted toward corridor view window • Room has a provision for a computer and supplies storage • Standardized room size, layout • Charting alcove with window • Appropriate lighting St Joseph’s Hospital, St Paul, Minnesota

  11. DON’Ts • Small windows • Centralized nursing stations • Closed private rooms with more privacy • Presence of blind spots • Improper alignment of beds • Large unit sizes with poor sightlines

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